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transference

Therapists tell you little about themselves, especially their dreams. Why would they? The woolly, wild world of the unconscious might suggest the counselor is a rapist, murderer, or thief.

Looking at him through the lens of the dream makes the treatment about the practitioner, not about the patient. It cripples the client’s ability to project his own long-standing issues onto this person: react to the counselor as if he were a father or mother identical to the real dad or mom.

A crucial part of classical psychodynamic treatment relies on the client playing-out his long-standing relationship problems and historically driven expectations of trauma or rejection within the session. The patient is unaware, at first, of the “mistaken identity” going on, where his reactions are more about his own past than the practitioner. If the therapist reveals too much about himself, he risks becoming the man of his chaotic dreams to the patient, not a benign, but blank canvas upon which his client throws the paint of his own internal life.

Dream interpretation is an art, not a science. Its value is difficult to demonstrate, though some therapists swear by it. Too many possible interpretations, no way to validate them. Yet they can be helpful. Certainly they may enlighten. Regardless, dreams are hard for the patient to resist discussing. An open therapist needs to take in all the uncensored data provided, the better to serve him.

Though I claim no specialty in dream interpretation, what I offer here is a partial explanation to those who wonder about the kinds of dreams therapists have.

The simple answer is, I doubt they are much different from those of people of similar upbringing, temperament, and overall life experience. I might add two exceptions:

Certain kinds of dreams are recognized as symptoms within the diagnostic framework developed by the American Psychiatric Association. For example, one possible symptom of Post Traumatic Stress Disorder is: “Recurrent distressing dreams in which the content and/or affect (emotion) of the dream are related to the traumatic event(s).”

Conventional wisdom tells us that high achievers have recurring dreams dealing with things like being late or unready for tests. Since people with advanced degrees prepared well for examinations (and took so many of them), the unconscious disquiet of discovering you are not ready or present for a test, a crucial appointment, or a presentation requires no leap of insight. Many of us were either driven to succeed, afraid of failure, or both.

Ah, but this discussion is rather impersonal, so I will offer an actual dream of one person I know well and present you with two interpretations. Moreover, I invite you to take the interpreter’s role yourself: be the therapist.

Whose dream shall I speak of?

My own.

Get ready. Prepare yourself for the unexpected nature of the story. The partially unclothed aspect, too.

I was sitting in the smallest room of my old office suite. Yes, the washroom. Some vulnerability here, don’t you think?

The door to the W/C led to the waiting room, the lobby of the office suite. I shared the workplace with other therapists. Unexpectedly, one of those counselors opens the door to the washroom. A man. He walks through a side entrance I hadn’t noticed and was never there before. I pushed him out and spoke with him soon after.

The extra door was installed without my knowledge, he informed me. Even though all the other counselors rented the space from me, they somehow did this unilaterally, without discussion with me, and with no warning.

Several of them were in a meeting which I joined. I talked to them. I spoke of the danger to our patients, our duty to protect, and our professional liability. Since our clients all used this facility, I stated this unlockable entrance would constitute malpractice. The head of the group argued back, though I can’t recall the details of her rejoinder. The assembly of counselors was mostly docile and unpersuaded by my logic. In the end I went off, saw my next patient, and did my job.

What should be made of this, if anything? Well, I can recall failed attempts at rational persuasion dating back to my childhood. Mom ran the roost, like the female leader of the other therapists. My mother was a tough cookie and dad worshipped her. No amount of logic or effort were enough to effect changes in the family dynamic. Should I leave the interpretation at that or try another tack?

Let’s visit recent events as possible triggers of the sleepytime return to my professional practice. I read two disturbing books in the days before the dream. As Dr. Michael Breus notes, some believe dreams are “a means by which the mind works through difficult, complicated, unsettling thoughts, emotions, and experiences, to achieve psychological and emotional balance.”

The Souls of Black Folk by W.E.B. Du Bois and The Revolt of the Masses by José Ortega y Gasset both carry profound messages about the dark side of humanity. The first deals with American slavery, the second with the growth of a naïve, destructive, anti-intellectual “mass man” who may destroy the pillars of Western civilization. Du Bois led me to watch Slavery by Another Name, a superb, but equally unsettling documentary on the color-line that existed in the South even after the emancipation of blacks. Their forced-labor and imprisonment by legal and extra-legal means was new to me.

I was powerfully affected, but not, I thought, to the point of emotional distress. Still, these books and the movie offered a larger vista on what happens when reason fails and men know only rights and not duties to something virtuous and greater than themselves.

One more feature of my dream was a lack of control. Being interrupted in the washroom by a stranger is profoundly threatening. One is literally caught “with his pants down,” though I felt more surprised and angry in the dream than in danger.

The books also might have amplified my personal concerns about the current state of Western democracy: another possible precipitant of the strange story. If this is so, then perhaps I should alter my life: dip a toe into the ocean of earthly woe, not bathe in it. Rather ironic, in light of what I did during my career, which on some days was a daily if not hourly immersion.

Other interpretations are possible, of course, but I hope you get the idea.

Your own analysis might tell you about both yourself and me. Do remember, that the therapist must remove himself from his issues when doing therapy, including his investigation of dreams. Freud was a notable exception who performed a self-analysis.

So, you now get to be the psychologist. Complicated, isn’t it? Give it your best shot.

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The first image is called Think Different by Neotex555. It includes within it a statue plus a portion of Kandinsky’s Fugue, the entirety of which makes up the painting that follows. Finally comes Sean Foster’s Cloud Frenzy. All are sourced from Wikimedia Commons. For more about the function of dreams, you might want to visit a very fine post by Dr. Michael Breus.

Just as most people with cars will tell you they are better than average drivers, I suspect most of us believe we are pretty good at knowing others: estimating their worth, determining their reliability, pegging their level of integrity.

Not so fast. Some of those confident in their capacity to size-up friends and strangers are poor at it, in my estimation. Here are a few of their (and our) possible errors:

Believing people are motivated in the identical way we are. This amounts to the expectation that you can judge another’s intentions and actions by asking the question, “What would I do in his shoes?”

The tendency to discard important evidence about personality. I wish I had a million dollars for every time a female patient uttered, “Oh, he wouldn’t do that to ME.” The action they referred to was a betrayal, almost always sexual. The man, of course, had already revealed a history of infidelity. Call this willful blindness by the unlucky lady.

Sticking with a wrong opinion. Some of us are slow to revise a long-standing error. Even if our original measure of an individual is right, we are in danger of failing to register subtle changes morphing him into something less honorable. One might also miss the ripening of a condemned personality into someone sweeter. It is as if, once done labeling, we are free to put our brains asleep. Richard Posner, a public intellectual and judge, rightly asks the question, “If we sentence a 21-year-old man to life in prison, are we still punishing the same man when he is 71?”

The difficulty of thinking psychologically, Part I. Most of us base our understanding on surface impressions. A plausible explanation of a person’s behavior “makes sense.” Freud knew better. Actions can be determined by multiple motivations. Many of those are unconscious. A quick acceptance of a single reason to explain the world risks simplifying the complex.

The difficulty of thinking psychologically, Part II. In observing others we tend to assume a personality is something objective, like pulse or blood pressure or height. Might it be more accurate to think of mental makeup as a creation of our perception, a combination of what we encounter in the other and how we interpret what we encounter? To a significant extent we translate our experience of a man, his words and actions, filling in the many blanks with our history of similar persons and a few educated guesses. Much is lost in translation. This is usually done without careful study, no training, by instinct. How else might you account for the neighbor of an ax-murderer telling the TV reporter he appeared to be a good guy?

We tend to believe the best of members of our in-group and those we are attracted to.

We tend to believe the worst of those we dislike, members of an out-group, and people against whom we compete. They become stereotypes.

The influence of the opinions communicated by friends, relatives, and co-workers. Research demonstrates we are influenced by group opinions even if asked to estimate which of several straight lines is the longest, discounting what our senses tell us if the rest of those present offer different answers. We do not form judgments in a vacuum. Millions of advertising dollars are spent on attempts to modify thought and action — yours and mine.

We believe people will behave in the same way regardless of the situation. Few of us observe even our best friends in a variety of circumstances. We don’t watch them preparing their tax forms, at work, or facing a moral dilemma. Courage is in short supply. Not everyone can resist taking a surreptitious unfair advantage. Self-interest is a powerful motivator and easily rationalized. Evidence for this opinion is to be found in the large number of political candidates who throw in their lot with a yahoo-like scoundrel and justify it by loyalty to their party.

Expecting others to be consistent and whole, all good or all bad. Again, public office-seekers provide the example. They are flawed, as are we. Yet there is the tendency to understand people globally, as undifferentiated and organically whole: honest or dishonest, virtuous or criminal, black or white. The best person on earth has secrets, has made mistakes, and will make more. No man deserves a halo, but many benefit from a halo effect or are harmed by its opposite.

Our limited perspective. We experience everyone from a unique view point: through our eyes and our buzzing brains. The reason pollsters sample large groups is because any one person doesn’t reflect everyone’s opinion. We bring to our understanding of life a very particular set of experiences and beliefs that shade and transform all we think and observe.

A tendency to judge others more harshly than ourselves. “I wouldn’t have done what he did” is easy enough to say (and thus condemn) because we are not in the identical situation as the one being judged. “He should have known she was no good” is an opinion lacking knowledge of all the history, emotion, and experience which might explain a failure to “know.” Meanwhile, automatic psychological defenses blind us to our own foibles.

The shifting perspective created by aging. How can a 20-year-old fully understand a 40-year-old? How can a sixty-year-old understand a 20-year-old? Not only do these people have the advantage or disadvantage of years, but of times. Life today is not what it was in the ’50s or ’60s or ’90s. Time machines cannot take you forward and back with appropriate adjustments of your age.

Transference. Transference is not limited to the counselor’s consulting room. It is like a mistaken identity. While we might have feelings for the therapist derived from our relationship to a parent, we can also react this way to a stranger or friend, a lover or a boss. They too may remind us unconsciously of some other past human contact and reproduce many of the sensations and emotions evoked by the original person.

The intentionally misleading quality of public faces. Humans try to make themselves “presentable,” just as a gift, an award, or an object of art is better looking when dusted off, retouched, and nicely framed — now suitable for viewing. X-ray vision through and beyond the public face is unavailable, Superman excepted.

The influence of our off-kilter emotions. Here is an example of how feelings can distort our estimation of another. An insecure person prone to injury by a word or a look is more likely to believe the other harbors a negative attitude toward him, thus overestimating his neighbor’s dark side.

Though subject to the foibles just described, I nonetheless possess considerable experience (personal and professional) in trying to understand others. If I am better than most in making those judgments, I am far from perfect. To whatever extent I can demonstrate success, it is because I benefited from large data sets for thousands of patients with whom I spent many hours. They offered information often not provided to those closest to them. I received instruction in the manner of asking questions, analyzing the answers, administering and interpreting psychological tests, formal education, and supervision. And still I am not perfect.

We do our best, therapists or not, to hone the observational knife to the point of precise dissection of another personality. Or we do it casually — all too confident — and don’t look back. No one, however, gets a complete grasp of the social world. To do that we would have to be both inside the other and outside of him, combining the perspectives of those who know him best and those who are more distant — like a baseball game viewed from different angles by multiple cameras.

A 24/7 off-the-field videographer might help too, making his visual record during all the hours before and after the contest, even when our subject is asleep. We would also need to speak with our subject’s lover, children, business partners, garbage man, and valet, if he has one. Not to mention the person who does his laundry.

And there is the rub, my friend. Not even your therapist wishes to know everything about you.

—

Are YOU Playing Square? is a World War II poster of the Office for Emergency Management (Office of War Information). It requires a bit of explanation. During World War II the US government created rationing and price controls on certain commodities. This was done to ensure that the people at home faced no shortages, while the armed forces were themselves well-supplied. Nonetheless, a black market existed in which one could get more than one’s proper share of a rationed commodity by paying an inflated price. Thus, “playing (fair) and square” meant respecting the rules, not participating in the black market. The poster is meant to suggest that cheating undermined the war effort and thereby endangered the soldier pictured. The second image of Wisdom is the work of Matt Lawler. Both of these pictures were sourced from Wikimedia Commons.

You think of your therapist as a special person, at least some of you do. His kindness and attention can not only generate gratitude, but affection. You are aware of his boundaries and you can be frustrated by a professional stance limiting the kind of contact you’d like: a favored position, not someone put into a time slot with a financial transaction attached. Perhaps, however, there is more to this than an ethical code. Why might his viewpoint as a therapist make what you want difficult to obtain? And, no, I’m not talking about sex.

Consider the role you play and the role he plays. You are likely talking about emotionally charged issues. Your feelings are front and center. His are not. Indeed, he is thinking about what you are feeling and doing.

You come to the clinician because of problems on which you are intensely focused. Thus, you are internally directed to your issues. The counselor, on the other hand, is not attending to his concerns, but to yours. He is looking outward, you are looking inward.

The counselor is not exposed. While you can find out some things about him, the treatment is not about him. You do not keep his secrets, but he wants to keep yours. You are encouraged to open yourself in order to heal. He is closed, assuming a relative position of safety and authority no matter how much he tries to be gentle and helpful.

Your session is of singular importance to you. It is one of many sessions for him, focused on you and a full complement of other patients. That makes him more important to you than you are to him. It does not mean he is indifferent to you. The doctor may well have tender feelings for you and enjoy your company, care genuinely, and approach you somewhat differently from the way he approaches others. Still, he is your only therapist, while you are not his only patient.

The counselor spends a limited time with you. He will then meet with someone else and switch his concern to the newly arrived individual. In a sense, however much he is concentrating on you while you are with him, he must develop an ability not only to be “in the moment” with you, but switch to another person after a brief interval. You do not switch. When you leave, your concern is still on yourself and the relationship with the therapist. A mental health professional is like an athlete in this way. After the game is over, he quickly puts the contest behind him so he is able to bring all his skill and attention to the next game.

To the extent that the therapist makes himself a blank slate and reveals little about his life, it is thought you will play out your emotional issues in the form of transference: experiencing him, to some degree, as similar to an important person or persons in your life, especially if your parental relationships are unresolved. Your transference toward him provides important material which he will help you work through. In doing so, you cut the trip wires of the past that continue to harm you in the present.

The counselor, of course, can also have countertransference toward you: experiencing you and reacting to you as if you are someone about whom he has unresolved feelings. However, to the extent he gets to understand the intimate details of your life, he is likely to be less prone to such emotions than you are in response to him. You are not a blank slate to the therapist. Thus, his likelihood of projecting his issues on you is at least a bit less probable.

Now let’s switch focus. Imagine what therapy would be like if these conditions were not typical of a therapeutic interaction. In which case:

The therapist would reveal as many of his issues as you do of yours.

He would be focused on himself as much as on you.

He would have less control over his emotions in session.

You might come to know disqualifying things about him.

The counselor might break down in session when you are overwrought or because of his own life problems outside of the office.

Consolation from you may well be required to stabilize him.

When you are in session he could be preoccupied with the last patient he saw before you.

Your relationship to him would approximate the kinds of contact you have with friends and co-workers.

I wrote this essay for the purpose of helping you understand a therapist’s perspective, his limitations, and his boundaries. Without those walls, little benefit comes from treatment. This is not to say your therapist doesn’t care about you. It is to say his care must remain within limits. In the absence of those limits, no matter how much you believe you’d like something more, counseling leads to something less.

Sometimes in life we do not know what is best for us. Then we are lucky — very, very lucky — that our wishes are not granted.

Patients wonder what their therapist is thinking. Therapists wonder what their patients are thinking. It is not much different from what happens between husbands and wives, parents and children, bosses and employees — or is it?

I’ve written about what doctors think about their patients before: What is Your Therapist Thinking? But today I’ll focus on what the patients are thinking about their counselor and how therapists are “supposed to” handle that. I say supposed to, because we don’t always do it well. It is one of the trickiest parts of a counselor’s job.

Patients have feelings and expectations about a counselor, in part, because he resembles someone else. This is called transference. In other words, the client’s sense of this new person is transferred from someone else who is important to him, simply because the new acquaintance resembles the old one. It happens automatically and without thinking; a kind of mistaken identity.

No, you don’t think your therapist has red hair if his hair isn’t actually red. But you do see him through the lens of your past experiences, and react to him because of certain real or imagined similarities to others. All of us do this in all sorts of relationships. It occurs whenever we have unconscious feelings and assumptions about someone who reminds us of someone else; which is a lot, even if we don’t know it. The feelings toward the old person (be it a parent, a sibling, a boss, or a lover) can become quite mixed up with the real human qualities of any new individual, including a new therapist.

Indeed, this is made easier by the fact that the therapist limits how much the patient knows about his personal life. In effect, the shrink is a kind of blank slate upon which the client “fills in the blanks” left empty by a lack of real information. Not surprisingly, all of us are prone to repeating old behavior patterns in new relationships; and, to the extent that a new person evokes old feelings about what the relationship is and what it can become, the transference can play out the patient’s repeated relationship difficulties right in the therapist’s office.

Take a hypothetical situation. Let’s say that your dad was a hard guy. He was critical of you, didn’t give you enough attention, and seemed to favor your siblings. Now, many years later, you meet your new therapist. Is he any of these things? To some extent it doesn’t matter. For example, the fact that your shrink only sees you once a week can reopen the tender wound of your neediness — your failure to win your father’s time and attention. You might feel that your doctor isn’t as available as you’d like him to be, in person or on the phone. You might interpret some of his statements as being disinterested, even when they are not so intended.

The counselor can be more important to you than he would otherwise be because of your unresolved, unconscious desire to get the affection and approval of this admired authority figure, who, like all authority figures, can easily remind you of dad. The hurt and/or anger that you feel when the shrink does not fill your need for a “good” father is almost inevitable. You might want to leave therapy because of it.

What is a therapist supposed to do when this happens? If he reacts defensively to the patient’s demands or disappointments, he is unlikely to do him any good. In fact, the counselor who responds angrily can create one more injury of the same kind that was inflicted by the patient’s father, thereby adding to the client’s mistrust and misery. Even if the healer tries hard to give him what only a father can give, the patient will still not be satisfied. After all, the therapist cannot literally fulfill the childhood yearnings that come from anyone’s vanished youth. The hunger of a 10-year-old for good parenting can no more be satisfied when he is 30 than can a literal hunger for a good meal at age 10 by a delicious dinner 20 years later.

What the therapist can do is the following. First, he can be compassionate and understanding. He often anticipates that the patient’s old losses and resentments (his past disappointments concerning his dad) are likely to play out in the therapeutic relationship. When they do, the psychologist will try to gently assist the client to see that the feelings bubbling up are not fully appropriate, but come from the historical emotions attached to the father that have been superimposed onto the shrink. If the patient is open to exploring this, he will gradually be able to purge his internally complicated connection to his parent. This is a grieving process, a cathartic expression and understanding of the sadness and/or anger that continue to live inside of him, even if the parent is dead.

If all goes well in therapy, the therapist will eventually no longer evoke the transferential emotions; no longer remind the patient of the parent. And not only will his relationship with the therapist be less complicated, but so will all those other interactions with lovers, bosses, or friends which used to unconsciously trigger the same feelings. Finally, the old injuries will be healed sufficiently to be set aside, clearing the way to better social interactions in the future.

I am certainly not saying that all of the feelings that patients have about their doctors are mistaken. Therapists have the same potential flaws as everyone else. They can be good or bad, attentive or unreliable, too easily hurt or too distant. Some want your admiration and some don’t much care. They have feelings about the patient that grow out of their own relationship history. This is called a countertransference. Regardless, the potential for the transferential issues I’ve described is always there, just as the therapist’s countertransference toward the patient must be carefully watched to prevent the damage that it can do.

Do you find all of the above some sort of psychobabble that doesn’t apply to you? Trust me, transference is real. The more that you believe your relationships are “logical” and that your past doesn’t reach into your present, the more that it probably does, unless of course you have dealt adequately with it in some sort of therapeutic process, whether in treatment with a professional or in your own self-analysis.

Therapy and transference are much more complicated than I’ve described. What you’ve read is a simplification based on a hypothetical relationship between a father and his adult child who is in therapy. If you are not in therapy, even if your relationships are going quite well, it still may benefit you to take a look at patterns of connection you make with friends or lovers: the kind of people you are drawn to and the types of individuals who usually “push your buttons,” get you angry, or disappoint you in some way. We can all learn a lot by just connecting-the-dots of our life history, seeing the resemblances among the people who keep returning, even if their names are different the second or twenty-second time around.

It is easy to blame others when relationships fail. Relationships aren’t easy. But, the more unsatisfactory and repetitious your social life is, the more likely that something in you needs attention.

—

The top painting is called Therapyby Gerhard Gepp. Apparently, the patient (a soccer ball or football) is thinking about being kicked around. Might he have transferential feelings toward the therapist and feel badly treated by him, as well? The second image is a photograph of Sigmund Freud in Session with aPatient, from the Seventh International Sand Sculpture Festival in Portugal. The artist is RHaworth. Finally, a cartoon of Freud Treating Moses by Moa1. All are sourced from Wikimedia Commons.

Welcome!

In addition to psychology, you'll also find me musing on baseball, classical music, love, friendship, how we live, and how best to live. I'll tell a few stories and draw a few conclusions.
I hope that some tales will touch you and others help you to look at yourself and the world anew. Thanks for reading (and thinking) along with me! Your comments are most welcome.

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